A Step-By-Step Guide To Measuring Sleep

How to take the actual first step towards a healthier lifestyle with various digital health tools and methods is among the questions we receive the most often. That is why we decided to compile a step-by-step guide to help anyone set up better routines, regardless of the devices they own/don’t own.?Let's start with measuring sleep.

As the journey towards optimal digital health should unequivocally begin with sleep, this is where we begin. It has the greatest health gains relative to the investment of time and money. “This was also my starting point, and to this day, it remains the most meaningful aspect of my health regime.” - Dr. Meskó, The Medical Futurist declared when we discussed this topic for this analysis.

Sleep quality varies significantly among individuals, influenced by a blend of genetic factors and lifestyle choices. A recent study published in the Journal of Child Psychology and Psychiatry sheds light on this. The research, involving 2,458 children, found that kids who were genetically predisposed to insomnia, based on a polygenic risk score developed for adults, experienced more insomnia-like sleep issues such as frequent awakenings or difficulty initiating sleep. Conversely, those predisposed to longer sleep durations tended to have lengthier sleep but also experienced more wakefulness during the night in adolescence.

This study provides indirect evidence that the genes predisposing adults to insomnia may also contribute to poor sleep from toddlerhood through adolescence, suggesting the existence of a 'poor sleeper' trait that persists throughout a lifetime.

Regardless of our genes, we don't learn as children how to achieve (the best possible) quality sleep nor understand what good sleep specifically means for us as individuals.

We previously have written about sleep tracking multiple times, you can also check back here for example.?

Let’s quickly get over a few basic questions!

Is it fundamental to have eight hours of sleep every night??

No, you don’t necessarily need eight hours of sleep each night – actually, we don’t know yet exactly how much sleep your organism craves. But why would a standardised rule determine our bedtime when we know that everyone has a different body and different needs?

That’s when sleep tracking comes into the picture.

Can we make up for lost sleep time on the weekend??

Well, no matter how it seems, based on research that’s not happening . On top of that, this study suggests that sleep regularity - how consistently you keep your bedtime / wake-up time from day to day is an important predictor of mortality risk and is a stronger predictor than sleep duration. In other words, social jetlag - when people live more according to the social clock (local time) during the working week and more according to their biological clock (circadian clock) on work-free days - is not ideal.

Is snoozing truly overrated?

Definitely not! Although Gallup has reported that over the past 50 years, we have been sleeping one hour less per night than we did back in the 1950s. Moreover, many people take pride in sleeping as little as possible – especially on college campuses or in the tech sector and Silicon Valley , saying they’ll sleep when they are dead. Well, inadequate shuteye can eventually lead there – it is long known that sleep deprivation has even been used for a long time as a means of interrogation by many secret services, including the CIA .

What matters the most?

So, to make the most of the sleep issue, we have to consider?

• the quality of sleep (which needs to be tracked for you somehow as you are sleeping and thus unable to play a role)
• the quantity of sleep (ditto)
• and?how energized you feel in the morning

This process is intrinsically personal and involves a lot of trial and error.?

When it comes to beginning your sleep-tracking journey, starting simple is key. As you very likely already have a smartphone, the most cost-effective way to start is with a sleep-tracking app . These apps can provide a surprising amount of insight without any financial investment. As you become more invested in understanding and improving your sleep, you might consider upgrading to more advanced tools like a smartwatch or an under-mattress sensor.

Each level of investment offers its benefits. While apps are an excellent starting point, devices like smartwatches and sensors offer more detailed data and can track additional aspects of your sleep. The key is to balance your budget with your desire for detailed sleep data and remember that the ultimate goal is to enhance your sleep quality and overall well-being.

Getting deeper

I only have my smartwatch to provide sleep insights and even that is a quite new feature in my life after buying a capable new watch in December. This was a tough decision as the old one still works perfectly. (Yes, I’m a laughing stock in the team as well for this old-world sentimentalism.)

Of course, the black-belted master of sleep tracking is Dr. Meskó within The Medical Futurist premises. In his two-decade-long quest for better sleep, he experimented with various methods: standalone apps like Sleep as Android, dozens of various wearables, under-mattress sensors, and combinations of these tools. Each method has its unique strengths and can offer insights into different aspects of your sleep.

In his pursuit of the most accurate sleep tracking, he’s found that for him?

the best results come from a combination of a smartwatch and an under-mattress sensor. This pairing works well because each device compensates for the other's missing data, providing a more comprehensive view of sleep patterns.?

He uses Withings' devices for this purpose, but everyone needs to find the combination that works best for them.

What to make of your REM, core & deep sleep cycles?

As we are all genetically different, we need different factors during our sleep to feel rested the next day. But to make observations for yourself, you need to have info about your sleep phases.

Most apps (and wearables) divide your nighttime into four segments:?

• Awake
• REM sleep
• Core/Light sleep
• Deep sleep

REM is named after the rapid eye movement that happens during this stage. During REM the brain is incredibly active, this is the part of our sleep where we dream, process and store memories.?(Sleep experts claim REM is not the only phase for doing that, but let’s settle with this thought for now).

What we (the apps) call the core/light sleep period is defined as two different sleeping stages by sleep experts, but let’s just stay with the app classification. This is the light sleep period we spend approximately half of our nights in, and this is the stage in which you want to be awakened by a smart sleep alarm.?

And lastly, we also have deep sleep periods, which is the time when the body does maintenance. Also known as restorative sleep, the brain activity is reduced, the heart rate and respiratory rate drops, and we grow muscles and regrow tissues in deep sleep. Deep sleep typically happens in the first half of our nights and these segments last 20-40 minutes in each sleep cycle for an average person. But there is great personal variance in this as well.?

The good, the bad and the eminent one

The reason that finally convinced me to invest in a new watch while having a perfectly working old one was anxiety. As a new contestant in the Sleeping Terribly arena, I wanted to see what happens on those nights when I feel like I don’t sleep. I was aware of the fact that I was not actually awake the whole night, but it certainly felt like it. Like the night in the middle of this image.?

Well, the data eminently shows that despite having enough-ish hours spent asleep, my shut-eye is terribly fragmented, with a crazy number of awakenings and very little time spent in deep sleep. I slept less on the night in the first chart, but felt perfectly fine the next day, while the night in the middle left me like a zombie.?

In contrast, the last chart shows a night with excellent sleep, enough hours and enough deep sleep, with almost exactly 50% spent in light sleep and 25% in REM and deep sleep. Christmas holidays are less stressful than getting back to work, what a surprise…?

Getting started

According to Dr. Meskó, it is easy to start our journeys toward better sleep. Here is what he suggests based on his experiments.?

1. Start tracking your sleep however you can (with pen and paper, an app, your watch, sensor, or whatever you have).
2. Each morning, give a score between 1 and 10 to your sleep, based on how rested you feel, it is also fine if you just use an old-school notebook, nothing fancy is needed!?
3. Don’t get discouraged that things seem unchanged for a while.
4. And then suddenly, start noticing patterns, and get closer to what makes you feel the best in the morning. For Dr. Meskó it is to have at least one long - 60-minutes + - deep sleep period. But everyone is different!
5. Start noticing the factors that ruin your sleep. It may be stress, alcohol consumption, intense workout in the evening, too much screentime, screentime right before falling asleep, dinner too late, etc, etc.?
6. Learn the ideal sleep quantity, as (for example) having the desired amount of deep sleep alone won’t make you feel perfectly rested if you don’t have enough hours. The optimal amount of sleep varies a lot, it can be 7 hours for one person and 8 and a half for another.
7. Find the right time for getting up. It is very different getting aroused from deep or light sleep, making a huge difference in how you feel in the morning - or, as Dr. Meskó declared: a smart sleep alarm is the holy grail of health tracking .?

I’m still having bad nights, so what’s the point?

Tracking sleep won’t make all our nights perfect. I have bad days due to stress. Dr. Meskó has a newborn in the house, also not ideal for sleep quality. However, knowing what we can do to make the best of our current situations is the whole point of tracking sleep.?

Your nights may not be perfect, but with the right tools, info, and mindset, you can make the most of what you have.

If you still feel like wanting to read more about the topic, here Dr. Meskó summarized the major steps we can take to measure sleep, and what we can learn from sleep data . And of course, let’s not forget about the holy grail of sleep tracking: the smart sleep alarm .

Getting sleep insights offers the lowest-hanging fruits of the whole digital health methodology, you can’t start with anything else offering such gains in health benefits. So don’t hesitate to start it, and if you have questions, reach out to us, we are happy to help!